December Edition â Happiness - UK Faculty of Public Health

More documents

Recommendations

Info

SPECIAL FEATURE: HAPPINESSEat your greens tobeat the blues?A RECENT analysis* has looked at therelationship between fruit and vegetableconsumption and mental health in threerobust, representative, cross-sectionalstudies of adults in England, Scotland andWales. Each survey gathered self-reportedintake data, measured in portions of up toeight or more a day, whereas most surveysstop at the recommended five or more.They also gathered data using differentmeasures of mental health – mentalwellbeing (WEMWBS), mental illness (GHQ-12), life satisfaction, happiness,nervousness and feeling downhearted.Together these surveys capturedinformation from more than 80,000 peopleand took account of factors such as age,sex, ethnic group, socioeconomic andeducational circumstances and otherlifestyle factors such as smoking. Theyshow a consistent dose-responserelationship between mental health andportions of fruit and vegetables consumed:the more fruit and vegetables consumedthe more mental wellbeing. In modelsbased on indicators of positive mentalhealth (WEMWBS, life satisfaction andhappiness) coefficients increased up toseven or more portions. In models basedon mental health problems (GHQ-12,nervousness, feeling downhearted) theyincreased up to five or more.While a strong and consistent doseresponserelationship, as shown in thesestudies, is pretty powerful evidence thatfruit and vegetable consumption isinfluencing mental health, the possibilityremains that the surveys could just bedocumenting the fact that people withThe more fruit andvegetables consumedthe more mental‘wellbeingbetter mental health tend to look afterthemselves better than those without.We already know that increasing fruitand vegetable consumption would meet awide range of public health goals includingreduced cardiovascular disease and cancer.If it could be shown that fruit andvegetable consumption make a differenceto wellbeing, public health messages toincrease consumption would be greatlyenhanced.If it could also be shown for certain thatfive portions a day is not optimal formental health, public health messageswould also need to change. With theevidence available from this study, it ispossible to claim that this is likely to be so,but we urgently need prospectivesupplementation studies to prove thingsone way or another.Sarah Stewart-BrownProfessor of Public HealthWarwick Medical School‘* Blanchflower DG, Oswald AJ, Stewart-Brown S. Is psychological wellbeing linkedto the consumption of fruit and vegetables?Social Indicators Research 2012 Epub 11October DOI10.1007s/11205-012-0173-yPutting moodson the mapTHE aim of ‘mood-mapping’ is to helppeople and groups understand, measure,compare and manage how they feel. Atpresent mood is measured withquestionnaires or on a scale using factorssuch as anxiety or wellbeing, depression orenergy. Mood-mapping is a visual, nonculturalassessment of mood that is easy tolearn and apply. It measures mood in themoment and can show how immediatecircumstances affect how a person feels.The technique separates mood intoenergy and positivity. The four quarters ofthe graph describe four basic moods: action,stress, tiredness and calm (see Fig). Theindividual plots their ‘mood point’ byestimating how much energy and howpositive they feel. The mood point can belabelled with the time and circumstances. Ifrequired, an intervention can be offeredand its effect on mood assessed.Numerous studies show the benefit ofinterventions and environment on health,wellbeing and energy levels. Moodmappingcan be used as a simple selfassessmenttool alongside five approachesto managing mood: the environment,physical health, relationships, cognitivestrategies and individually specific factorsto improve how people or groups feel(Miller L, Healthcare Counselling &Psychotherapy Journal 2011: 2; 17-19).Mood-mapping is a simple way ofvisualising how people feel andencouraging them to have greater controlof their emotions, better understand howtheir actions affect their health and stresslevels, and take more responsibility for theirwellbeing. This self-help approach isespecially useful in times of austerity. Fromthe perspective of public health, the toolcould perhaps be validated to allow thehealth and stress levels of a population tobe measured and compared.Liz MillerGP and occupational health physicianREVALIDATIONRevalidation guideYour pull-out-and-keep manual for the new systemThere are a number of aspects of revalidation about which the Faculty of Public Health frequently receives queries from members. We’vedeveloped this pull-out-and-keep guide to give you the essential facts about revalidation. Working with colleagues in the field, we’vedeveloped this guidance to help those working as public health professionals, as well as those appraising them. You can find this andfurther information on our website at: www.fph.org.uk/supporting_information_for_gmc_revalidationFROM THE VICE PRESIDENTIT HAS been a long time coming but, atlast, revalidation to the General MedicalCouncil (GMC) is about to commence.The regulations that bring revalidationinto our professional lives were enabledon 3 December 2012.For most of you, there will be littlechange in your annual appraisals,merely a strengthening of existing localprocesses. For those of you not used toannual appraisals, which are the basisof revalidation, you will need tofamiliarise yourself with the requirements.These pages will help all readers toprepare for revalidation to the GMC, toensure they are aware of therequirements, the types of supportinginformation they will be required toreflect on and present at their annualMain types ofsupportinginformationAN IMPORTANT part of revalidation isthe building, over a period of five years, ofa portfolio of supporting information thatdemonstrates your practice against the 12attributes of Good Medical Practice.The supporting information that you willneed to bring to your appraisal will fallunder four broad headings:n General information – providing contextabout what you do in all aspects of yourworkn Keeping up to date – maintaining andenhancing the quality of your professionalworkn Review of your practice – evaluating thequality of your professional workn Feedback on your practice – how othersperceive the quality of your professionalwork.There are six types of supportinginformation that you will be expected toprovide and discuss at your appraisal atleast once in each five-year cycle. They are:appraisal. More detail is available on therevalidation pages of our website atwww.fph.org.uk/revalidationBringing supporting information toappraisal may be new to many of you,and the GMC has specified six types ofsupporting information for you toprovide over the five-year revalidationcycle. This information, which you willreflect on and discuss at your annualappraisal, will demonstrate your practiceagainst the attributes outlined in GoodMedical Practice.In discussing your supportinginformation, your appraiser will beinterested in what you did with theinformation and your reflections on thatinformation, not simply that youcollected it and maintained it in aportfolio. Your appraiser will want toknow what you think the supporting1. Continuing professional development2. Quality-improvement activity3. Significant events4. Feedback from colleagues5. Feedback from patients (if you seepatients)6. Review of complaints and compliments.The nature of the supporting informationwill reflect your particular specialist practiceand your other professional roles. Yourportfolio will make it easier for yourappraiser to complete the appraisal and foryour Responsible Officer (RO) to make arecommendation to the GMC about yourrevalidation. If you feel that you are unableto collect all pieces of supportinginformation you should discuss the matterwith your appraiser. The requirements arethe same for all doctors.information says about your practiceand how you intend to develop ormodify your practice as a result of thatreflection. For example, how youresponded to a significant event andany changes to your work as a result,rather than the number of significantevents that occurred.The UK Public Health Register(UKPHR) will be introducing a system ofrevalidation based on annual appraisal.More details will follow in due course,so please do check the UKPHR and FPHrevalidation webpages.For trainees, your Annual Review ofCompetence Progression will cover thenecessary requirements.Edmund JessopVice President for Standards andResponsible Officer, FPHGuidance onauditEVIDENCE of quality-improvement activityis mandatory for revalidation; it providesevidence that you review your practice,learn from any mistakes and improve as aresult. Audit (which consists of audit, takeaction and re-audit) is a requirement onceevery five years, and two case reviewsshould be produced in the interim fouryears. FPH has provided some examples ofaudit and case review in the main areas ofpublic health as guidance for appraiseesand appraisers.10 PUBLIC HEALTH TODAYDECEMBER 2012 11
REVALIDATIONREVALIDATIONMulti-sourcefeedbackguidanceTimelinesTHE GMC will write to all doctors startingin December 2012 to confirm the date atwhich it expects to receive arecommendation about the doctor’s fitnessto practise. It is aiming to tell every licenseddoctor their recommendation date byspring 2013 at the latest. It will give aminimum of three months’ notice of whenthe doctor’s revalidation recommendationshould be submitted but will let them knowearlier if it can.The GMC’s schedule is as follows:n (Year 0) December 2012 to March 2013:All ROs and other senior medical leaders tobe revalidatedn (Year 1) April 2013 to March 2014: FirstRO recommendations (20% of doctors)submittedn (Year 2) April 2014 to March 2015:Second tranche of recommendations (60%of doctors) submittedn (Year 3) April 2015 to March 2016: ThirdReflective notesFEEDBACK from colleagues and patients ismandatory for revalidation. Feedback fromcolleagues will need to be gathered by alldoctors. Those of you who do not treatpatients will not need to provide this typeof feedback.Which multi-source feedback (MSF)questionnaire you should use is the decisionof your Responsible Officer (RO), and it isexpected that doctors will follow the localprocess as determined by the RO.The General Medical Council (GMC) haspublished guidance on the minimumrequirements for the first cycle whichincludes guidance on the MSF. Theguidance states that the MSF does not haveto be GMC-approved for the first cycle, butit must have been carried out within thefive years prior to the recommendation dateand relevant to the doctor’s current scopeof practice.tranche of recommendations (majority ofdoctors) submittedn End of March 2018: All remaininglicensed doctors. End of first cyclen April 2018: Second revalidation cyclebegins.While a revalidation recommendation ismade once every five years, you will beexpected to undergo an appraisal everyyear.REFLECTION is an important aspect ofrevalidation, as a driver by which you canimprove the quality of your professionalpractice. You will need to reflect on thesupporting information within your portfolioand document that reflection as a way ofproviding insight into your work and, inturn, informing the appraisal discussion.Good reflection goes beyond descriptiveobservation. It demonstrates evidence ofanalytical thinking, learning and actionplanning. The intention is that you provideinsight into your supporting informationand, in turn, your professional practice,approach to medicine and demonstratecompliance with Good Medical Practice.To help with this important aspect of CPDand revalidation, FPH has produced Tips onWriting Effective Reflective Notes.Minimumrequirements fora revalidationrecommendationTHE General Medical Council (GMC) hasset out guidance for doctors on theminimum requirements for the first cycle.In order to be ready to have a revalidationrecommendation made about them, doctorswill have to fulfil the following criteria:n The doctor must be participating in anannual appraisal process which has GoodMedical Practice as its focus and covers theentire scope of their medical practice.n The doctor must have completed at leastone appraisal, with Good Medical Practiceas its focus, which has been signed off bythe doctor and their appraiser.n The doctor must have demonstrated,through appraisal, that they have collectedand reflected on the following informationas outlined in the GMC’s guidanceSupporting Information for Appraisal andRevalidation:– continuing professional development– quality-improvement activity– significant events– feedback from colleagues– feedback from patients (if applicable)– review of complaints and compliments.n Evidence of continuing professionaldevelopment, review of significant eventsand review of complaints and complimentsmust relate to the 12-month period priorto the appraisal that precedes anyrevalidation recommendation.n Evidence of regular participation inquality-improvement activities thatdemonstrates the doctor reviews andevaluates the quality of their work must beconsidered at each appraisal. The activityshould be relevant to the doctor’s currentscope of practice.n Evidence of feedback from patients andcolleagues must have been undertaken noearlier than five years prior to the first revalidationrecommendation and be relevant tothe doctor’s current scope of practice.n Feedback from patients and colleaguesthat does not fully meet the criteria set bythe GMC may also be included but musthave been:– focused on the doctor, their practiceand the quality of care delivered to patients– gathered in a way that promotesobjectivity and maintains confidentiality.n Team-based information may also meetthe requirements where no individualisedinformation is available for qualityimprovementactivities, significant events orcomplaints and compliments – as long asthe doctor has reflected on what thisinformation means for their individualpractice.Specialty specific guidanceFPH has worked with the Academy of Medical Royal Colleges to produce specialty-specific guidance that will be used by appraisers,appraisees and Responsible Officers who require further guidance on the particularities of revalidation in public health. The guidanceincludes this helpful checklist for supporting information that should be used in conjunction with the remainder of the guidance.Remember: it is your responsibility to ensure the information you supply is correct and up to date.GENERAL INFORMATIONPersonal detailsScope of workRecord of annualappraisalsPDPsa General Medical Council (GMC) numbera demographic and relevant personal information and qualificationsa self-declaration of no change or an update identifying changesa description of whole practice covering the period since last appraisala current job plan (if required for reference)a any significant changes in professional practicea extended clinical and non-clinical activitiesa any other relevant information for field of practicea signed-off appraisal portfolio record and satisfactory outcomes of previous appraisala evidence of appraisals (if undertaken) from other organisationsa confirmation that previous actions/concerns have been addresseda current personal development plan (PDP) with agreed objectives from previousappraisala details of any new objectives added since last appraisal or to be addeda access to previous PDPsAnnualAnnualAnnualAnnualProbity a signed probity self-declaration AnnualHealth a signed health self-declaration AnnualKEEPING UP TO DATECPD a description of CPD undertaken each year as set out in requirements AnnualREVIEW OF PRACTICEQuality improvement activity – at least one of the following activities as appropriate for specialty (see full guidance)Clinical audit a evidence of demonstrating active engagement in complete audit cycle Minimum 1 in 5 yearsReview of clinicaloutcomesCase review ordiscussiona documented review of clinical outcomes, as where defined by specialtya documented case reviewsSignificant eventsClinical incidents, a summary of all SUIs or root-cause analyses that you have been involved inSignificant Untoward a summary of at least 2 clinical incidents per year ORIncidents (SUIs) ora self-declaration that you have not been involved in any events.other similar eventsIf availableAnnual in remainingyearsAnnualFEEDBACK ON PRACTICEColleague feedback a MSF colleague feedback exercise (normally by the end of year 2). Minimum 1 in 5 yearsFeedback frompatients and/or carersFeedback from clinicalsupervision, teachingand trainingFormal complaintsa patient-feedback survey or equivalent exercise, normally by the end of year 2(if applicable).a evidence of performance as a clinical supervisor and/or trainer (a)a feedback from formal teaching included annually (b)a documented formal complaints received ORa self-declaration that none have been received since last appraisalMinimum 1 in 5 years(a) Minimum 1 in 5years (b) annualAnnualCompliments a summary of unsolicited compliments received Annual12 PUBLIC HEALTH TODAYDECEMBER 2012 13
Page 1 and 2: THE FINAL WORD‘ ’ Wellbeing is
Page 3 and 4: INTERVIEWINTERVIEWDuncan Selbie is
Page 5: SPECIAL FEATURE: HAPPINESSSPECIAL F
Page 9 and 10: SPECIAL FEATURE: HAPPINESSWatching,
Page 11 and 12: ENDNOTESENDNOTESA spotlight on...Ro

December Edition â Happiness - UK Faculty of Public Health

Create successful ePaper yourself

Delete template?

Save as template?

December Edition â Happiness - UK Faculty of Public Health